TY - JOUR
T1 - Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma
T2 - A population-based study
AU - Geyer, Susan M.
AU - Morton, Lindsay M.
AU - Habermann, Thomas M.
AU - Allmer, Cristine
AU - Davis, Scott
AU - Cozen, Wendy
AU - Severson, Richard K.
AU - Lynch, Charles F.
AU - Wang, Sophia S.
AU - Maurer, Matthew J.
AU - Hartge, Patricia
AU - Cerhan, James R.
PY - 2010/6/15
Y1 - 2010/6/15
N2 - BACKGROUND: Smoking, alcohol use, and obesity appear to increase the risk of developing non-Hodgkin lymphoma (NHL), but to the authors' knowledge, few studies to date have assessed their impact on NHL prognosis. METHODS: The association between prediagnosis cigarette smoking, alcohol use, and body mass index (BMI) and overall survival was evaluated in 1286 patients enrolled through population-based registries in the United States from 1998 through 2000. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox regression, adjusting for clinical and demographic factors. RESULTS: Through 2007, 442 patients had died (34%), and the median follow-up for surviving patients was 7.7 years. Compared with never smokers, former (HR, 1.59; 95% CI, 1.12-2.26) and current (HR, 1.50; 95% CI, 0.97-2.29) smokers had poorer survival, and poorer survival was found to be positively associated with smoking duration, number of cigarettes smoked per day, pack-years of smoking, and shorter time since quitting (all P <0.01). Alcohol use was associated with poorer survival (P = 0.03); compared with nonusers. Those drinking >43.1 g/week (median intake among drinkers) had poorer survival (HR, 1.55; 95% CI, 1.06-2.27), whereas those drinkers consuming less than this amount demonstrated no survival disadvantage (HR, 1.13; 95% CI, 0.75-1.71). Greater BMI was associated with poorer survival (P = 0.046), but the survival disadvantage was only noted among obese individuals (HR, 1.32 for BMI ≥30 vs BMI 20-24.9; 95% CI, 1.02-1.70). These results held for lymphoma-specific survival and were broadly similar for diffuse large B-cell lymphoma and follicular lymphoma. CONCLUSIONS: NHL patients who smoked, consumed alcohol, or were obese before diagnosis were found to have a poorer overall and lymphoma-specific survival.
AB - BACKGROUND: Smoking, alcohol use, and obesity appear to increase the risk of developing non-Hodgkin lymphoma (NHL), but to the authors' knowledge, few studies to date have assessed their impact on NHL prognosis. METHODS: The association between prediagnosis cigarette smoking, alcohol use, and body mass index (BMI) and overall survival was evaluated in 1286 patients enrolled through population-based registries in the United States from 1998 through 2000. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox regression, adjusting for clinical and demographic factors. RESULTS: Through 2007, 442 patients had died (34%), and the median follow-up for surviving patients was 7.7 years. Compared with never smokers, former (HR, 1.59; 95% CI, 1.12-2.26) and current (HR, 1.50; 95% CI, 0.97-2.29) smokers had poorer survival, and poorer survival was found to be positively associated with smoking duration, number of cigarettes smoked per day, pack-years of smoking, and shorter time since quitting (all P <0.01). Alcohol use was associated with poorer survival (P = 0.03); compared with nonusers. Those drinking >43.1 g/week (median intake among drinkers) had poorer survival (HR, 1.55; 95% CI, 1.06-2.27), whereas those drinkers consuming less than this amount demonstrated no survival disadvantage (HR, 1.13; 95% CI, 0.75-1.71). Greater BMI was associated with poorer survival (P = 0.046), but the survival disadvantage was only noted among obese individuals (HR, 1.32 for BMI ≥30 vs BMI 20-24.9; 95% CI, 1.02-1.70). These results held for lymphoma-specific survival and were broadly similar for diffuse large B-cell lymphoma and follicular lymphoma. CONCLUSIONS: NHL patients who smoked, consumed alcohol, or were obese before diagnosis were found to have a poorer overall and lymphoma-specific survival.
KW - Alcohol
KW - Non-Hodgkin lymphoma
KW - Obesity
KW - Smoking
KW - Survival
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U2 - 10.1002/cncr.25114
DO - 10.1002/cncr.25114
M3 - Article
C2 - 20564404
AN - SCOPUS:77954020406
SN - 0008-543X
VL - 116
SP - 2993
EP - 3000
JO - Cancer
JF - Cancer
IS - 12
ER -